TX HHS Form H1122. Medicaid Action Notice

The TX HHS Form H1122, Medicaid Action Notice, is a crucial document that helps solve the problem of ensuring accurate and timely information for Medicaid eligibility. This form is typically filled out by individuals who are receiving Medicaid benefits, particularly pregnant women, to report changes in their household or medical expenses.

This notice requires important information from the individual, including proof of pregnancy due date, spend down amounts, and medical bills. The form also outlines specific responsibilities, such as notifying the caseworker within 10 days of any changes in pregnancy status. Additionally, it emphasizes the importance of sending all medical bills to the Clearinghouse as soon as possible.

Key features of this form include reporting changes in household or medical expenses, providing required information by a specific date, and ensuring that Medicaid benefits are not affected. The following key points summarize the requirements and situations where this form is used:

• Pregnant women receiving Medicaid must report their due date and notify their caseworker of any changes within 10 days.
• Individuals must provide required information, such as spend down amounts and medical bills, by a specific date to avoid case denial.
• The form is used to ensure accurate and timely information for Medicaid eligibility and to prevent delays or denials in benefits.